Egypt reports more H5N1 cases and deaths

Feb 17, 2010 (CIDRAP News) – The World Health Organization (WHO) today confirmed two H5N1 avian influenza cases from Egypt, one of them fatal, and reported that two previously announced Egyptian patients have died from their infections.

Initial details about the new fatality, a 29-year-old woman from Elsadat district in Menofia governorate, were announced by Egypt's health ministry on Feb 15. The woman, who was pregnant, got sick on Feb 6 and was hospitalized and received oseltamivir (Tamiflu) on Feb 12. She died the following day.

The other case is in a 32-year-old man from Ashmon district in Menofia governorate who got sick on Feb 6 and was hospitalized 2 days later. He has received antiviral treatment and is in stable condition, according to information the WHO received from Egypt's health ministry.

Investigations into the two cases revealed that both patients were exposed to sick and dead poultry. The two illnesses mark Egypt's 98th and 99th H5N1 cases.

Egyptian officials also reported two deaths in previously announced cases. They involve a 37-year-old man from Helwan governorate who got sick on Jan 31 and was previously listed as Egypt's 97th H5N1 case-patient, and a 29-year-old woman from Elsadat district in Menofia governorate who got sick on Jan 27 and was previously announced as the 96th case-patient. These two deaths, plus the newly announced fatal case, raise the number of fatal H5N1 infections in Egypt to 30.

Egypt has recorded nine cases and three deaths from the H5N1 virus so far this year. The infections seem to be striking mostly adults this year, a change from 2009 when young children seemed to bear the greatest disease burden. Of the nine H5N1 infections reported to the WHO so far, seven have occurred in adults—four women and three men.

It's unclear why the virus is hitting adults harder this year, but a report in the Jan 28 issue of Eurosurveillance suggested that Egyptian women may have more exposure to the virus, because they do the bulk of poultry culling, slaughtering, and defeathering. The report also said Egyptian adults aren't hospitalized as quickly as children, which could increase their death rates. Studies have shown patients infected with the H5N1 virus are more likely to survive their infections if they receive early antiviral treatment.

The country has reported dozens of poultry H5N1 outbreaks this year, most of them in household birds, though the virus has struck some commercial farms.

The new Egyptian cases and deaths raise the global H5N1 total to 478 cases, which include 286 fatalities.